Workers' Compensation FAQ
On these pages you will find answers to some of the most frequently asked questions we receive about the process of filing for Workers' Compensation and Social Security Disability benefits. The questions and answers below give you an idea of what to expect if we represent you. However, every case is unique. If, after reading this, you have additional questions, please do not hesitate to call. Also, please do not discuss your case with or seek advice from anyone except your lawyer. If you are contacted by your employer, your employer's insurance carrier or a vocational counseling/rehabilitation agency, please refer them to Blaufeld Schiller & Holmes LLP and forward to us any correspondence you have received in that regard. Any direct contact without our participation may jeopardize your case.
The following information is meant to be general in nature and should not be construed as specific legal advice on any individual case.
What is Workers' Compensation?
Pennsylvania passed its first Workers' Compensation Act in 1915 to provide monetary compensation to workers injured in the course of doing their jobs, regardless of fault. The term "injury" includes occupational disease, repetitive and wear-and-tear type injuries, as well as traumatic injuries, such as hearing loss.
What does Workers’ Compensation cover?
Workers’ Compensation is a no-fault system which pays for lost wages and medical expenses if you are hurt on the job. Wage loss benefits are available for total disability if you are unable to work. Partial disability benefits may be paid if you are working but receiving reduced wages due to your work illness or injury. Death benefits are also available to dependents of workers who are killed on the job. Benefits are also available for specific losses or loss of use of certain body parts, including sight and hearing. Scars may also be compensable if they are on your face or neck.
Who files my Workers' Compensation claim?
Blaufeld Schiller & Holmes LLP files the claim on your behalf with the Bureau of Workers’ Compensation in Harrisburg. We also see that your employer and employer’s insurance company, if known, receive copies of the petition.
What happens after the claim is filed?
You and our office will be notified that the petition has been assigned to a Workers’ Compensation Judge. A few weeks later, the Judge will notify you of when and where your hearing will occur. Typically, the location is somewhere in or near the county in which you live. Read notices carefully so you appear at the right place and time. We will confirm the information with you as well.
When do I meet with my lawyer?
We will meet with you before first hearing and any subsequent hearings.
How many hearings will there be?
Typically, there are more than one, sometimes as many as three or four. Your employer may present witnesses at a second or later hearing.
What should I expect at a hearing?
We will prepare you before the hearing where you will testify under oath about your injury or disability. In addition, a lawyer for your employer or employer’s insurance carrier will cross-examine you. Be sure to arrive at the hearing location as instructed by your lawyer, so you and your lawyer can make final preparations.
Who is asked to testify?
If your disability involves more than 52 weeks of compensation, we will ask your doctor to testify. This usually takes place in a deposition at the doctor’s office under oath before a court reporter. Your lawyer and the employer’s lawyer each question the doctor. In Workers’ Compensation cases, most medical evidence is gathered in this way. If your disability involves fewer than 52 weeks of compensation, however, your doctor’s reports may be sufficient. In addition, either side may have other witnesses testify by deposition. All testimony is considered in the Judge’s final decision.
How long does it take to receive a decision?
It is not unusual to receive a decision one year or more after the petition is filed. Many factors can influence the course of a case, including availability of witnesses, the Judge’s schedule and the complexity of the case. Once the case is filed, the Judge, not our firm, controls the schedule. When the Judge makes a decision, he/she will send the written decision to you, our firm and the other parties.
Can I appeal the Judge's decision?
Yes. Anyone who disagrees with any part of the decision may appeal, including you. If there is an error of law in the Judge’s decision, it may be overturned on appeal. However, no new evidence is taken during an appeal. If the Judge decides the case based on the credibility of the witnesses, it is not likely that the decision will be overturned. Appeal arguments are held before the Workers’ Compensation Appeal Board. You will be notified, but need not appear. If an appeal is appropriate, we will represent you at the appeal and file a supporting brief.
Will I be paid benefits during the appeal process?
Usually the defendant (your employer) requests that no benefits be paid during the appeal process. This request is called a Petition for Supersedeas. However, we will file an opposition. If the Appeal Board denies your employer’s petition, you will be paid benefits during the appeal if you won. The decision on Supersedeas is an interim order and cannot be appealed. If you lose your case and an appeal is filed on your behalf, you will not receive benefits unless the appeal is successful.
Who actually pays my Workers' Compensation benefits?
If your case is successful, your employer or the employer’s insurance carrier will pay your benefits, usually bi-weekly, along with all reasonable and necessary medical expenses resulting from your work injury.
Can I also collect for pain and suffering from my injury?
No. Workers’ Compensation does not cover pain and suffering or lost fringe benefits. While this may seem unfair, it is important to remember that the issue of negligence is removed by law from Workers’ Compensation. You do not have to prove that your employer’s negligence caused your injury and disability. Even if your own negligence caused the injury and disability, your employer cannot use that as a defense to avoid paying the claim.
How is the amount of my benefits determined?
Your benefit rate is based on your average weekly wage during the twelve months preceding your injury. Generally, you will receive two-thirds of that amount, up to a State maximum.
Why is it important to have a lawyer?
The Workers’ Compensation laws have become increasingly more complicated in recent years. It is important to understand all parts of the law and the effect your actions may have on your right to benefits. Your employer will always be represented by experienced counsel who will try to keep you from getting your benefits.
How does my lawyer get paid?
We receive a fee only if we win your case. It is all explained in a written fee agreement you sign when you retain our firm and which is presented to the Workers’ Compensation Judge at the first hearing. The Judge orders the attorney’s fee to be paid only if we are successful. The fee is usually 20% of your award or settlement.
Once I start receiving benefits, do I still need a lawyer?
Many things can happen after benefits are awarded. There may be changes in the Workers’ Compensation Law and/or your right to receive benefits. The employer or insurer may try to terminate compensation benefits or may begin vocational rehabilitation. They may begin to question or challenge your medical treatment or medical bills. In any of these situations, it is important that you be represented.